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. 2021 Jul-Aug;15(4):102146.
doi: 10.1016/j.dsx.2021.05.019. Epub 2021 May 21.

Mucormycosis in COVID-19: A systematic review of cases reported worldwide and in India

Awadhesh Kumar Singh  1 , Ritu Singh  2 , Shashank R Joshi  3 , Anoop Misra  4
Affiliations

Mucormycosis in COVID-19: A systematic review of cases reported worldwide and in India

Awadhesh Kumar Singh et al. Diabetes Metab Syndr. 2021 Jul-Aug.

Abstract

Background and aims: There are increasing case reports of rhino-orbital mucormycosis in people with coronavirus disease 2019 (COVID-19), especially from India. Diabetes mellitus (DM) is an independent risk factor for both severe COVID-19 and mucormycosis. We aim to conduct a systematic review of literature to find out the patient's characteristics having mucormycosis and COVID-19.

Methods: We searched the electronic database of PubMed and Google Scholar from inception until May 13, 2021 using keywords. We retrieved all the granular details of case reports/series of patients with mucormycosis, and COVID-19 reported world-wide. Subsequently we analyzed the patient characteristics, associated comorbidities, location of mucormycosis, use of steroids and its outcome in people with COVID-19.

Results: Overall, 101 cases of mucormycosis in people with COVID-19 have been reported, of which 82 cases were from India and 19 from the rest of the world. Mucormycosis was predominantly seen in males (78.9%), both in people who were active (59.4%) or recovered (40.6%) from COVID-19. Pre-existing diabetes mellitus (DM) was present in 80% of cases, while concomitant diabetic ketoacidosis (DKA) was present in 14.9%. Corticosteroid intake for the treatment of COVID-19 was recorded in 76.3% of cases. Mucormycosis involving nose and sinuses (88.9%) was most common followed by rhino-orbital (56.7%). Mortality was noted in 30.7% of the cases.

Conclusion: An unholy trinity of diabetes, rampant use of corticosteroid in a background of COVID-19 appears to increase mucormycosis. All efforts should be made to maintain optimal glucose and only judicious use of corticosteroids in patients with COVID-19.

Keywords: COVID-19; Corticosteroids; Diabetes mellitus; Mucormycosis; Systematic review.

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Conflict of interest statement

Declaration of competing interest We hereby declare that we have no conflict of interest, related to this article titled “Mucormycosis in COVID-19: A Systematic Review of Cases Reported Worldwide and in India”.

Figures

Fig. 1
Fig. 1
Postulated interaction of diabetes, corticosteroid and COVID-19 with mucormycosis.
See this image and copyright information in PMC

Comment in

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